Diagnostic Accuracy of Screening Tools for Delirium in Adults Receiving Care in Intensive Care Units: A Systematic...

Delirium is a common, critical condition in adults receiving care in intensive care units, requiring effective screening tools for early detection. To systematically compare the diagnostic performance of delirium screening tools for adults receiving care in ICUs, we conducted a comprehensive search across nine databases up to August 1, 2025, followed by a network meta-analysis of diagnostic test accuracy. Fifty studies involving 6042 patients were included. The S-PTD demonstrated optimal diagnostic performance, with high pooled sensitivity (0.922) and specificity (0.977). The CAM-ICU showed outstanding specificity (0.949), whereas the DDS exhibited poor sensitivity (0.302). In conclusion, the CAM-ICU and ICDSC are widely used; the S-PTD performs excellently but requires validation in adults receiving mechanical ventilation, and the 4AT exhibits balanced accuracy but is unsuitable for adults receiving mechanical ventilation. The NEECHAM and DDS have limitations, particularly the DDS, which exhibits low sensitivity and may fail to accurately identify cases of delirium. High-quality validation studies and uniform DSM-5 use are recommended. Trial Registration: This study has been registered with PROSPERO (CRD42024534483).